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Can stories influence African-American patients' intentions to change hypertension management behaviors? A randomized control trial.
Patient Educ Couns. 2016 09; 99(9):1482-8.PE

Abstract

OBJECTIVES

Information-only interventions for hypertension management have limited effectiveness, particularly among disadvantaged populations. We assessed the impact of viewing African-American patients' stories of successfully controlling hypertension on intention to change hypertension management behaviors and engagement with educational materials.

METHODS

In a three-site randomized trial, 618 African-American Veterans with uncontrolled hypertension viewed an information-only DVD about hypertension (control) or a DVD adding videos of African-American Veterans telling stories about successful hypertension management (intervention). After viewing, patients were asked about their engagement with the DVD, and their intentions to change behavior. Mean scores were compared with two-sided t-tests.

RESULTS

Results favored the Stories intervention, with significantly higher emotional engagement versus control (4.3 vs. 2.2 p<0.0001). Intervention patients reported significantly greater intentions to become more physically active (4.6 vs. 4.4, p=0.018), use salt substitutes (3.9 vs. 3.4, p=0.006), talk openly with their doctor about hypertension (4.6 vs. 4.5, p=0.049), and remember to take hypertension medication (4.8 vs. 4.6, p=0.04).

CONCLUSION

Patients were more emotionally engaged and reported intentions to change behavior when watching real patient hypertension management success stories.

PRACTICE IMPLICATIONS

Stories may be more influential than information alone, and represent a scalable approach to modifying behavioral intention.

Authors+Show Affiliations

Center for Healthcare Organization and Implementation Research, ENRM Veterans Affairs Medical Center, United States; Department of Health Law Policy and Management, Boston University School of Public Health, United States. Electronic address: Barbara.Bokhour@va.gov.Center for Healthcare Organization and Implementation Research, ENRM Veterans Affairs Medical Center, United States; Department of Health Law Policy and Management, Boston University School of Public Health, United States. Electronic address: Gemmae.Fix@va.gov.Center of Innovation for Complex Chronic Healthcare, Jesse Brown Veterans Affairs Medical Center, United States; Section of Academic Internal Medicine, Department of Medicine, University of Illinois at Chicago College of Medicine, United States. Electronic address: Howard.Gordon@va.gov.Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz/Philadelphia VA Medical Center, United States; Division of General Internal Medicine, University of Pennsylvania School of Medicine, United States. Electronic address: jalong@upenn.edu.Center for Healthcare Organization and Implementation Research, ENRM Veterans Affairs Medical Center, United States. Electronic address: Kathryn.Delaughter@va.gov.Center for Healthcare Organization and Implementation Research, ENRM Veterans Affairs Medical Center, United States. Electronic address: Michelle.Orner@va.gov.Ralph H. Johnson VA Medical Center, United States; Medical University of South Carolina College of Nursing, United States. Electronic address: Charlene.Pope@va.gov.Center for Healthcare Organization and Implementation Research, ENRM Veterans Affairs Medical Center, United States; Division of Health Informatics and Implementation Science, Quantitative Health Sciences, University of Massachusetts Medical School, United States. Electronic address: Thomas.Houston@va.gov.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27387121

Citation

Bokhour, Barbara G., et al. "Can Stories Influence African-American Patients' Intentions to Change Hypertension Management Behaviors? a Randomized Control Trial." Patient Education and Counseling, vol. 99, no. 9, 2016, pp. 1482-8.
Bokhour BG, Fix GM, Gordon HS, et al. Can stories influence African-American patients' intentions to change hypertension management behaviors? A randomized control trial. Patient Educ Couns. 2016;99(9):1482-8.
Bokhour, B. G., Fix, G. M., Gordon, H. S., Long, J. A., DeLaughter, K., Orner, M. B., Pope, C., & Houston, T. K. (2016). Can stories influence African-American patients' intentions to change hypertension management behaviors? A randomized control trial. Patient Education and Counseling, 99(9), 1482-8. https://doi.org/10.1016/j.pec.2016.06.024
Bokhour BG, et al. Can Stories Influence African-American Patients' Intentions to Change Hypertension Management Behaviors? a Randomized Control Trial. Patient Educ Couns. 2016;99(9):1482-8. PubMed PMID: 27387121.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can stories influence African-American patients' intentions to change hypertension management behaviors? A randomized control trial. AU - Bokhour,Barbara G, AU - Fix,Gemmae M, AU - Gordon,Howard S, AU - Long,Judith A, AU - DeLaughter,Kathryn, AU - Orner,Michelle B, AU - Pope,Charlene, AU - Houston,Thomas K, Y1 - 2016/06/21/ PY - 2016/02/04/received PY - 2016/06/17/revised PY - 2016/06/21/accepted PY - 2016/7/9/entrez PY - 2016/7/9/pubmed PY - 2017/7/18/medline KW - African-American KW - Disparities KW - Education KW - Health literacy KW - Hypertension KW - Narrative communication SP - 1482 EP - 8 JF - Patient education and counseling JO - Patient Educ Couns VL - 99 IS - 9 N2 - OBJECTIVES: Information-only interventions for hypertension management have limited effectiveness, particularly among disadvantaged populations. We assessed the impact of viewing African-American patients' stories of successfully controlling hypertension on intention to change hypertension management behaviors and engagement with educational materials. METHODS: In a three-site randomized trial, 618 African-American Veterans with uncontrolled hypertension viewed an information-only DVD about hypertension (control) or a DVD adding videos of African-American Veterans telling stories about successful hypertension management (intervention). After viewing, patients were asked about their engagement with the DVD, and their intentions to change behavior. Mean scores were compared with two-sided t-tests. RESULTS: Results favored the Stories intervention, with significantly higher emotional engagement versus control (4.3 vs. 2.2 p<0.0001). Intervention patients reported significantly greater intentions to become more physically active (4.6 vs. 4.4, p=0.018), use salt substitutes (3.9 vs. 3.4, p=0.006), talk openly with their doctor about hypertension (4.6 vs. 4.5, p=0.049), and remember to take hypertension medication (4.8 vs. 4.6, p=0.04). CONCLUSION: Patients were more emotionally engaged and reported intentions to change behavior when watching real patient hypertension management success stories. PRACTICE IMPLICATIONS: Stories may be more influential than information alone, and represent a scalable approach to modifying behavioral intention. SN - 1873-5134 UR - https://neuro.unboundmedicine.com/medline/citation/27387121/Can_stories_influence_African_American_patients'_intentions_to_change_hypertension_management_behaviors_A_randomized_control_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0738-3991(16)30289-0 DB - PRIME DP - Unbound Medicine ER -